I’m seeing blood in mom’s pull-ups (Because brand). I can’t tell if it’s urinary or vaginal bleeding. Before I call our doc I’d like to be able to narrow down the problem. Any ideas on how to tell the difference? She’s not having any pain or burning on urination but because the commode is shared with her husband, and we use commode liners with a gelling agent, I can’t tell anything there either. Thanks.
I suggest you read this 33 page booklet ( a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Here is a list of useful tips from her e-book I found to be excellent:
The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently
Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behavior to adapt to the dementia because the person with the disease cannot.
Best of luck.
As it turns out, I believe the blood was from a hemorrhoid. Will discuss with the doc when he visits.
One other question: My dad is driving me absolutely crazy by second-guessing me all that time. He tells me I’m in charge of things, then the next minute he makes a decision about something (usually wrong and inappropriate) and I have to fix things. He tried 3 times in 5 minutes this evening to share cantaloupe with mom who’s having diarrhea at the moment. Nothing I say or do sticks with him. Any advice?
When I noticed blood in the toilet after urination, my doctor sent me for a bladder scan (colposcopy) to eliminate the possibility of bladder cancer (I was post menopausal at the time). The test was negative and that was that. Sometimes there is blood in the urine from something as simple as a broken blood vessel, but it's up to your mother's doctor to make a decision about the next step to take.
Good luck.
how much blood
pink diluted or bright fresh blood
what does it look like
how frequently do you observe it
when did you first notice it
whether there are any clots
If there's any question of its being cause for concern, she'll need to be examined anyway.
In general it's a bad idea to suggest a source or a cause to doctors or nurses because it tends to narrow their focus: you say "I think it's coming from her urethra," they immediately think uti (especially if you have scientific credibility, as you would do) and may (although they shouldn't) be less likely to exclude other possible causes of blood in a pull-up.
If their thinking after an examination doesn't include something you were expecting it to, that's when you can ask the question.
If your Mom, "my mom (88) has brain injury related memory issues"
how do you know if she can express her pain to you?
If you receive enough "caregiver advice" to have her seen by her doctor, will you be following that advice?
If you want to diagnose the bleeding yourself, you can try this:
Do not share the commode with another patient.
Answer this:
How much blood?
Did it happen again?
Fresh blood?
What color is the blood?
Can you insert a gloved finger with vaseline into her rectum to determine if the blood is coming from her anus?
Discovering all that, if you can, will you be taking her to the doctor?